Newborn know-how

Posted on 3 March 2015

For first-time parents it’s hard to know when baby behaviour indicates a problem. Dr Stephan Reid, a paediatrician at Mediclinic Potchefstroom, answers common questions.

What is too much or too little sleep?
Sleep goes hand-in-hand with feeds. As a general rule, in the first two weeks the baby should have at least four to six feeds in 24 hours. If it’s less than this, there’s potentially a problem. A newborn should not sleep continuously for longer than six hours without needing a feed. Breastfed babies feed more frequently, usually every two to four hours, so they can feed up to 10 times a day. Formula-fed babies may sleep up to four-and-a-half hours at a stretch but will still probably end up taking at least four to six feeds per day. Newborns should probably not be happily awake for longer than 30 to 60 minutes at a time. If they’re not sleeping enough, they get increasingly grumpy and can even have colic-like symptoms, causing them to scream or cry continuously.

A healthy baby shouldn’t feed more often than about every two hours. If they’re awake and want to feed all the time, you should definitely take them to the doctor. The most common reason is a feeding problem – baby’s probably not getting enough milk (which is usually evident from their lack of weight gain).

When does crying indicate a deeper problem?
Even though there’s been plenty of research in this area, we don’t really know what ‘normal’ crying is. Babies tend to cry a great deal: during the first two to four weeks, it’s usually because of hunger or a dirty nappy, or because they’re too hot or cold. Babies usually cry the most they ever will between one and two months, peaking at around six weeks. It’s normal for babies to cry for up to three hours in a 24-hour period at this stage. The intensity of crying varies, though, from baby to baby. The crying should not, however, be continuous. Any baby who cries intensively for more than two to three hours non-stop should be checked by a doctor.

When is it safe to take newborns outdoors?
There are no clear-cut guidelines here and it differs from parent to parent. However, the smaller the baby, the more fragile and susceptible to infection they are. The most potentially harmful time is in the first month, as their immune systems aren’t yet fully developed. In general, during the first one to three months it’s not advisable to take babies out among crowds. Breastfeeding is probably the most important protection for baby – there are factors built into breast milk that build immunity and prevent infection. Ask friends (and strangers) not to kiss the baby on their face or on hands – that’s how the baby can pick up infection. Rather ask people to kiss baby on the back of the head or on their feet. In addition, keep your baby and yourself away from someone who is ill.

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.